MRI分级诊断膝关节半月板损伤对手术的指导作用

Guiding Effects of MRI Grading Diagnosis of Meniscus Injury of Knee Joint for Operation

目的探讨MRI分级诊断膝关节半月板损伤对手术的指导意义。方法选取经MRI诊断为膝关节半月板损伤患者101例(135膝)为研究对象,根据膝关节半月板损伤MRI诊断标准分级,与关节镜下探查结果比较。结果 MRI诊断结果为Ⅰ级20个半月板,关节镜下正常17个,退变3个;MRI诊断Ⅱ级38个半月板,关节镜下正常2个,退变29个,损伤7个;MRI诊断级77个半月板,关节镜下有7个退变,70个损伤。MRI分级诊断膝关节半月板损伤的准确率为85.93%(116/135)。MRI诊断Ⅰ级患者20膝均未接受关节镜下手术处理,MRI诊断Ⅱ级患者7膝(18.42%)接受关节镜下手术处理,MRI诊断级患者70膝(90.91%)接受关节镜下手术处理,差异有统计学意义(P<0.05)。结论 MRI分级诊断与关节下诊断膝关节半月板损伤的准确性高,经MRI诊断为Ⅰ~Ⅱ级者可行保守治疗,MRI诊断为级者多需接受手术治疗。

Objective To study the guiding significance of MRI classification in the diagnosis of meniscus injury of knee joint.Methods 101 cases(135 knees)of patients with meniscus injury of knee joint and diagnosed by MRI were selected as the research objects.The results of the MRI diagnostic standard classification of meniscus injury of knee joint and the results of arthroscopic exploration were compared.Results The diagnostic results of MRI were that there were 20 cases of menisci in grade I:17 cases were normal under arthroscopy and 3 cases were degenerative.There were 38 cases of menisci in grade II:2 cases were normal under arthroscopy,29 cases were degenerative,and 7 cases were damaged.There were 77 cases of menisci in grade III:7 cases were degenerative and 70 cases were damaged under arthroscopy.The accuracy rate of MRI grading diagnosis of knee meniscus injury was 85.93%(116/135).Twenty knees of grade I diagnosed by MRI were not received arthroscopic surgery,7 knees(18.42%)of grade II diagnosed by MRI were treated by arthroscopic surgery,and 70 knees(90.91%)of III diagnosed by MRI were treated by arthroscopic surgery.The difference was statistically significant(P<0.05).Conclusion The accuracy of MRI grading diagnosis and joint diagnosis of meniscus injury of knee joint is high,and the patients of grade I-II diagnosed by MRI can take conservative treatment,but the patients of grade III are required to undergo surgical treatment.